Dylan’s Story – Pre-Departure

We’re now T-7 days from our departure from Ottawa to Kigali. I’ll be working with the “HRH” (Human Resources for Health) program, now beginning it’s 6th year. It’s a very large US program, which has aimed to rapidly increase the numbers of healthcare workers across specialties and professions in Rwanda. Critically, it aims to increase capacity for Rwandans to train these healthcare professionals  – the hope is that at the end of year 7, Rwanda will be in a good position to manage without the program. I’m also the Chair of CASIEF (the Canadian Anesthesia Society International Education Foundation), which has been working in a partnership with the University of Rwanda and American Society of Anesthesiologists, and over the last 11 years has created an anesthesia training program from nothing. After the genocide, there was only one physician anesthesiologist in the country; now there is a university training program with a chair, a program director and as many as 10 residents starting each year. It’s definitely time for Rwandan anesthesia to transition to independence from external support and it’s my main goal to support that transition. To work on this, I’ll be “twinned” with Paulin Ruhato, the chair of the department of anesthesia, and also with a new program director for the residency program. I hope to be in Kigali for 11 months.

I’ve been travelling a lot for global health work in recent years, spending around 25% of the year outside Canada. It’s been an amazing privilege to do this work, but has been hard on my wife, Chilombo, and my three girls (twins Namwezi and Wamaka, 8 and Mwamba, 5) and I’ve really missed them when way from Ottawa. One of the really exciting things about this next year is that we’re all going together as a family. I’m really looking forward to exploring a new country with them and I think it’s going to be a great and educational experience for the kids. Every major move is quite stressful, and I can’t say that thing have been easy. In particular, there has been a lot of uncertainly. My sub-contract with the University of Ottawa, who are paying me for the year, was only signed yesterday. The contract between Brigham and the University of Ottawa, so that Ottawa can recover those funds, has not even been sent on to us here in Ottawa yet, and may still take some weeks. It was only a few days ago that the Memorandum Of Understanding between Rwanda and Harvard even arrived in Boston. So it’s all been quite last minute (apparently it’s like this every year), but things feel like they are finally coming together: flights were booked last week; this Monday we found out that the twins had made it into the same school as Mwamba having been on the waiting list; our house in almost boxed up and into storage, with the property on the market for rental. There’s still a lot of work to do, and we all have things and people to say “goodbye” to but increasingly I just feel like I want to get on with it now, I can’t wait for my feet to be on the ground in Kigali.

I strongly feel that partnerships like HRH and CASIEF are an essential part of the solution to the global crisis in global anesthesia and surgery. The recent Lancet Commission on Global Surgery established that 5 billion people in the world lack access to safe, timely and affordable surgical care. Scaling up is needed, so it’s great to have the opportunity to be part of such a large program. I’ve also been fortunate in having some excellent support at home. The Department of Anesthesiology and Pain Medicine at the Children’s Hospital of Eastern Ontario voted unanimously to approve 11 months leave of absence, so I still have a job to come back to next summer! This has resulted in significant inconveniences for my home department, including having to train someone to do pediatric cardiac cases. The University of Ottawa has been amazingly supportive, especially the Vice-Dean Paul Bragg, who went above and beyond to work on contract issues – the combination of a lot of bureaucracy and uncertainty could easily have killed my involvement in this project without this kind of strong support. We’re also lucky to have such great neighbours who’ve been really helpful with moving and storing our stuff.